Nut-cracker syndromes: As one cause of unknown origin hematuria to nephrologists in spite of studies for hematuria
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:95A 1997
The authors present 5 patients with episodic gross hematuria attributed to the so-called "nutcracker syndrome", the compression of the left renal v. between the SMA and the aorta. 3/5 had renal biopsy, described as normal (but no comment if EM was done to rule out thin basement membrane). The diagnostic gold standard used was renal vein venography with manometry of left renal vein and v.cava: a gradient of 3mmHg and presence of collateral veins are diagnostic. Cystoscopy showed unilateral blood flow in 4/4 cases. Venous phase renography during angiography was not helpful. RBCs were not dysmorphic.
Comment: Surprisingly, authors did not use Doppler ultrasound, which was reported to be diagnostic by another group in the same city (Seoul, South Korea) Radiology 198:93-97, 1996. Proteinuria was not mentioned, but has been described in nutcracker syndrome Pediatric Nephrology 11:218-220, 1997. This abstract is useful in reminding us of this syndrome in the differential diagnosis of gross hematuria. (James A. Sondheimer MD, Wayne State University, Detroit, MI)
To go back use the BACK button on your browser. Otherwise click on the desired link to this article below:
ASN 30th Annual Meeting, San Antonio
Proteinuria/Hematuria : Diagnostic approach to hematuria